War Surgery 1914-18

This fascinating 258 page book by surgeons Tom Scotland and Steve Heys was launched today and should be available soon.

Details courtesy of Amazon listing.

This volume ... should be in the hands of all whose concern is with injuries of war and conflict ... No reader of this book will fail to realise the impact of the lessons of surgery in the Great War on the progress and advance of the science and art of Surgery itself. --Colonel Michael P M Stewart, CBE, QHS, MBChB (Abdn), FRCS, FRCS Tr & Orth L/RAMC, Honorary Surgeon to H.M. The Queen

A fascinating study of war surgery in World War I, where huge medical developments were made and the foundations of modern war surgery were laid World War I resulted in an enormous number of casualties who had sustained filthy contaminated wounds from high explosive shellfire, bomb and mortar blast, and from rifle and machine gun bullets. Such wounds were frequently multiple and severe, and almost invariably became infected. Surgical experience from previous conflicts was of little value, and it became quickly apparent that early surgical intervention with radical removal of all dead and revitalised tissue was absolutely vital to help reduce the chances of infections, especially the lethal gas gangrene, from developing. War Surgery 1914-18 explains how medical services responded to deal with the casualties. It discusses the evacuation pathway, and explains how facilities, particularly casualty clearing stations, evolved to cope with major, multiple wounds to help reduce mortality. There are chapters dealing with the advances made in anaesthesia, resuscitation and blood transfusion, the pathology and microbiology of wounding and diagnostic radiology. There are also chapters dealing with the development of orthopaedic surgery, both on the Western Front and in the United Kingdom, the treatment of abdominal wounds, chest wounds, wounds of the skull and brain, and the development of plastic and reconstructive surgery for those with terribly mutilating facial wounds. War Surgery 1914-18 contributes greatly to our understanding of the surgery of warfare. Surgeons working in Casualty Clearing Stations during the years 1914-1918 laid the foundations for modern war surgery as practised today in Afghanistan and elsewhere.

Nothing on those specific areas. It deals with sugery more in relation to the BEF in France and Flanders before the casualty was transferred to an HS. No doubt many of the surgical procedures used and developments made benefited Naval surgeons too.

Britain’s official medical history of the Great War ran to no less than 13 volumes (of which one covers veterinary services) and the volumes were printed limited runs of between just 1,000 and 1,500 copies. Thus finding a complete set is almost impossible – most local libraries having long felt it unnecessary to keep them even in their reserve collections.Buying a set is hugely expensive – current value is estimated to be between 2 – 3 thousand pounds - and even building a complete set a volume at a time can be a long and costly task; some of the more unusual volumes costing over £100 each. Of the sequence four cover the general history of the topic, two volumes cover surgery. Probably the best know of the histories is the much quoted a statistical volume. Whilst the editors of War Surgery 1914-1918 clearly cannot compete in depth with the two OH volumes which deal specifically with surgery, as far as I am aware, nowhere else has the subject been covered with such degree of accessibility and interest to Great War buffs and yet also appeal to medics and military historians.

What the book shows is that whilst the army’s medical services were by no means unprepared for war, they, like those in of the other combatant nations were unprepared, for the scale of the Great War and the destructive power of the weapons which would be employed. Equally plain is how early the R.A.M.C realised that its work in the Great War would need to improve and began to get on with their task.

Britain was fortunate that the basics of the RAMC were largely right, if undersized. Equally he number of outstanding surgeons and administrators who became involved were prepared, capable and determined to push at the contemporary medical thinking, the boundaries of medical treatment and logistical needs and thinking. With few hiccups in the chart, the Corps started to climb its very own a medical and organisational learning curve very early on. By 1915 it was developing, codifying and introducing life saving systems and techniques which saved the lives, and quality of survivors lives, who in previous conflicts would have died. After a valuable scene setting introductory chapter, the second reveals the development of means evacuation and treatment of the wounded. In eight chapters the development of anaesthesia, pathology, the use of X rays, orthopaedic surgery, the treatment of abdominal wounds (which at the outbreak of war were almost guaranteed killers) penetrating chest wounds, skull and brain wounds and plastic surgery are explored and explained.

The writing is clear, concise, expertly suited to those lacking medical knowledge, yet not passé to those in the medical game. The book’s many well chosen illustrations are greatly aided by printing on high quality coated-paper, the many charts clear and cogent. IIn short, it seems to me impossible to argue with the view of the book’s preface:“The unity of presentation and focus on the historical and clinical aspects of War surgery makes War Surgery 1914-1918 a unique exposition and a valuable reference to the scholar as well as the surgeon.”, And, although it is far too early to name my Great War book of the year, I have little doubt that War Surgery 1914-18 will be a major contender. It is a very valuable addition to any Greast QWar library.

Interests:Medicine in the Great War, 'Minor' Theatres, eg. the Balkans, Mesopotamia, Ireland, Women in the War, attempting a book [books!] on newly discovered Robert Graves work etc.

Posted 04 August 2012 - 04:28 PM

Jim, thankyou indeed for this, 'Buy now with 1-Click' was never clicked faster! Recently I have been spending time - such as I have - in a medical library, browsing through the bound copies of various journals 1914 - 1918, seeking out nuggets. The committment, effort, and organisation which went into addressing the War's medical and surgical challenges is truly impressive. Nor was this all accomplished in or around the RAMC. I last week turned up Frances Ivens' original 1916 paper on her treatment of Gas Gangrene at Royaumont. But nor was it all about acute treatment of the sick and wounded. A lot of work was done too towards rehabilitation, much of which remains relevant even today. Doubtless though we should no longer take as the touchstone of useful recovery of elbow function that a man could once more raise a cigarette to his lips!

Interests:Australian Army Nursing Service / hospitals on the Western Front / Lemnos

Posted 25 February 2013 - 06:35 AM

National Army Museum - Lunchtime Lectures - video archiveRecorded on 25 October 2012http://www.nam.ac.uk...surgery-1914-18Tom Scotland, a retired orthopaedic surgeon, discusses the improvements in the care of the wounded in casualty clearing stations and base hospitals in France during the First World War.